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The Lancet. Infectious Diseases Aug 2014Preterm birth and infectious diseases are the most common causes of neonatal and early childhood deaths worldwide. The rates of preterm birth have increased over recent... (Review)
Review
Preterm birth and infectious diseases are the most common causes of neonatal and early childhood deaths worldwide. The rates of preterm birth have increased over recent decades and account for 11% of all births worldwide. Preterm infants are at significant risk of severe infection in early life and throughout childhood. Bacteraemia, inflammation, or both during the neonatal period in preterm infants is associated with adverse outcomes, including death, chronic lung disease, and neurodevelopmental impairment. Recent studies suggest that bacteraemia could trigger cerebral injury even without penetration of viable bacteria into the CNS. Here we review available evidence that supports the concept of a strong association between bacteraemia, inflammation, and cerebral injury in preterm infants, with an emphasis on the underlying biological mechanisms, clinical correlates, and translational opportunities.
Topics: Bacteremia; Brain; Humans; Infant; Infant, Newborn; Infant, Premature; Inflammation
PubMed: 24877996
DOI: 10.1016/S1473-3099(14)70710-8 -
Clinical Microbiology and Infection :... Jun 2013
Topics: Bacteremia; Humans
PubMed: 23607298
DOI: 10.1111/1469-0691.12234 -
Danish Medical Journal Jul 2015Bacteremia is associated with increased morbidity and mortality, and ranks among the top seven causes of death in Europe and North America. The occurrence of bacteremia...
Bacteremia is associated with increased morbidity and mortality, and ranks among the top seven causes of death in Europe and North America. The occurrence of bacteremia has increased for decades while short-term prognosis has remained unchanged or improved only slightly. Consequently, we are facing an increased number of bacteremia survivors for whom we know little about long-term survival and causes of death. Contemporary knowledge on the epidemiology and outcome of bacteremia is important to assess its impact on public health and is a prerequisite for any effective prevention and improvement of prognosis. This thesis is based on data from a bacteremia database (The Danish Observational Registry of Infectious Syndromes) comprising all bacteremias in Funen County, Denmark, between May 1999 and December 2008. Data on bacteremias were cross-linked with various administrative and research healthcare registries and we conducted 3 studies on adult bacteremia patients with the aims: to investigate the occurrence of and trends in first-time bacteremia and distribution of microorganisms in the general population; overall and by place of acquisition (study I), to investigate the overall and daily incidences of bacteremia among hospitalized patients (study II), to investigate and compare long-term mortality and causes of death after bacteremia with the general population (study III). Study I: In a population-based observational study, we identified 7786 residents of Funen County with first-time bacteremia for an overall incidence rate of 215.7 per 100,000 person years including 99.0 for community-acquired, 50.0 for healthcare-associated and 66.7 for nosocomial bacteremia. The overall incidence rate decreased by 23.3% (95% CI, 17.8%-28.4%) from year 2000 to 2008 (3.3% per year, p<.001) due to decreasing rates of community-acquired bacteremia (3.7% per year, p < <0.001) and nosocomial bacteremia (4.2% per year, p<0.001). The incidence rate of healthcare-associated bacteremia remained more or less stable throughout the study period (p=0.17). The crude incidence rates decreased for Escherichia coli, Staphylococcus aureus, co-agulase-negative staphylococci and Streptococcus pneumoniae, and increased for Pseudomonas aeruginosa and enterococci species (p<0.05 for all the mentioned microorganisms). Regard-less of place of acquisition, the proportion of bacteremias caused by coagulase-negative staphylococci decreased while the proportion caused by Enterococcus species increased. Study II: In a multicenter hospital-based cohort study, we included 276,586 adult patients with 724,339 admissions to hospitals in Funen County for a total of 4,531,744 bed days. Among the hospitalized patients, we identified 10,281 first-time bacteremias per admission for an overall incidence of 14.2 per 1000 admissions and 23.6 per 10,000 bed days; highest for males, elderly individuals (> 65 years), and patients initially admitted to the Departments of Hematology, Nephrology, Internal Medicine, Urology or Oncology. The daily incidence was highest on the day of admission and declined rapidly to a low level on Day 3-7. Hereafter it increased steadily until Day 12 followed by more or less constant daily incidences. The daily incidences varied considerably with patient and clinical characteristics. Study III: In a population-based cohort study, we included 7783 patients with first-time bacteremia and 38,906 population controls matched on sex, year of birth and residency. We found that the cumulative mortality in bacteremia patients and population controls was 22.0% vs. 0.2% (30 days), 41.4% vs. 2.6% (1 year), and 75.8% vs. 36.6% (10 years). Bacteremia patients were consistently at increased risk of death compared with population controls throughout 12 years of follow-up and the risk of death remained 2-fold increased even among 5-year survivors of bacteremia (adjusted MRR: 2.1; 95% CI: 1.8-2.3). The most common causes of death after bacteremia were cancer and cardiovascular diseases. Compared with population controls, bacteremia patients were at the highest risk of death from genitourinary diseases and infectious diseases within 1 year of bacteremia. Among 1-year survivors of bacteremia, the risk of death was increased for all major causes of death compared with population controls. We conclude that the occurrence of bacteremia is decreasing in the general population. However, bacteremia is associated with a very poor short- and long-term prognosis and the risk of death remains increased for years compared with the general population. The most common causes of death after bacteremia are cancer and cardiovascular diseases. Among hospitalized patients, the incidence of bacteremia is highest within days of admission and varies with patient and clinical characteristics.
Topics: Academic Dissertations as Topic; Adult; Aged; Aged, 80 and over; Bacteremia; Cause of Death; Cohort Studies; Community-Acquired Infections; Cross Infection; Denmark; Female; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Prognosis; Registries; Risk Factors
PubMed: 26183054
DOI: No ID Found -
Acta Paediatrica (Oslo, Norway : 1992) Jan 2011To explore risk patterns for presumed and definite, early and late neonatal bacteremia.
AIM
To explore risk patterns for presumed and definite, early and late neonatal bacteremia.
METHODS
We studied 1106 extremely low gestational age newborns who survived until postnatal day 28. We defined early definite bacteremia as a positive bacterial culture in the first week and definite late bacteremia as a positive bacterial culture in week 2, 3 or 4. Bacteremia was presumed if antibiotics were given for more than 72 h despite negative blood cultures.
RESULTS
Risk patterns did not differ much for presumed and definite bacteremia in the first postnatal month. While maternal and pregnancy characteristics were associated with early bacteremia, neonatal comorbidities, especially NEC, were the main antecedents/correlates of late bacteremia. All four categories of bacteremia were associated with younger gestational age and lower birth weight. Infants with presumed and definite bacteremia had similar distributions of days of ventilation and oxygenation.
CONCLUSION
Definite and presumed late bacteremias have rather similar risk patterns, while those of early and late bacteremia differ appreciably.
Topics: Bacteremia; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Risk; Terminology as Topic; Time Factors
PubMed: 20712830
DOI: 10.1111/j.1651-2227.2010.01963.x -
Clinical Microbiology Reviews Jan 2009The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth... (Review)
Review
The human gingival niche is a unique microbial habitat. In this habitat, biofilm organisms exist in harmony, attached to either enamel or cemental surfaces of the tooth as well as to the crevicular epithelium, subjacent to a rich vascular plexus underneath. Due to this extraordinary anatomical juxtaposition, plaque biofilm bacteria have a ready portal of ingress into the systemic circulation in both health and disease. Yet the frequency, magnitude, and etiology of bacteremias due to oral origin and the consequent end organ infections are not clear and have not recently been evaluated. In this comprehensive review, we address the available literature on triggering events, incidence, and diversity of odontogenic bacteremias. The nature of the infective agents and end organ infections (other than endocarditis) is also described, with an emphasis on the challenge of establishing the link between odontogenic infections and related systemic, focal infections.
Topics: Bacteremia; Bacteria; Endocarditis; Gingiva; Humans; Incidence; Tooth
PubMed: 19136433
DOI: 10.1128/CMR.00028-08 -
African Health Sciences Dec 2021A prospective study of 130 patients attending the Government Dental and Maxillofacial Hospital (now Maxillofacial unit, Rivers State University Teaching Hospital), Port...
STUDY DESIGN
A prospective study of 130 patients attending the Government Dental and Maxillofacial Hospital (now Maxillofacial unit, Rivers State University Teaching Hospital), Port Harcourt, between August 2018 and September 2019.
OBJECTIVE
To examine the factors that affect the occurrence of a bacteremia associated with oral and maxillofacial surgical procedures, and the types of bacteria causing this bacteremia, and establish the need or otherwise for prophylactic antibiotics in, 'at risk' patients.
METHODS
130 healthy adult patients requiring various oral and maxillofacial surgical procedures under local anesthesia using 2% lidocaine with 1: 100,000 adrenaline, were screened bacteriologically to determine the occurrence of a bacteremia. 5 milliliters of venous blood was collected from the antecubital vein of each patient preoperatively and within 3 minutes postoperatively. The samples collected were cultured and bacteriological identification done and analyzed.
RESULTS
Bacteremia was found in 43 (33.1%) of 130 patients postoperatively. In patients undergoing extractions, bacteremia occurred more frequently when teeth were extracted due to inflammatory dental diseases. There was no statistical correlation between the occurrence of a bacteremia and the number of teeth extracted (p>0.05). Of the 70 isolates obtained postoperatively, 5 (6.4%) were aerobes, 51 (65.4%) were facultative anaerobes (including microaerophiles) and 14 (17.9%) were anaerobes. Among the facultative anaerobes (including microaerophiles), the most frequently isolated bacteria genera were species of (25.7%), . (17.1%) and (15.7%) and among the anaerobes, Bacteriodes spp. (8.6%) were the most frequently isolated. All the isolates were sensitive to azithromycin, amikacin, imipenem and meropenem. However, 3 (30%) of the isolates were resistant to amoxicillin, which is a commonly used drug for antimicrobial prophylaxis.
CONCLUSION
This study shows the occurrence of bacteremia in Nigerians following various oral and maxillofacial surgical procedures and that the observed bacteremia was not dependent on the patient's age or gender. This study emphasizes the need for antibiotic prophylaxis in those patients who are at risk of developing complications from bacteremia. Amoxicillin as this study shows will not be an effective antibiotic prophylactic agent in a majority of patients. The author therefore recommends the use of azithromycin as an alternative prophylactic agent in those patients.
Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteremia; Humans; Nigeria; Prospective Studies
PubMed: 35283954
DOI: 10.4314/ahs.v21i4.24 -
Clinical Microbiology and Infection :... Apr 2015Bacteraemia is associated with high mortality. Although many models for predicting bacteraemia have been developed, not all have been validated, and even when they were,... (Review)
Review
Bacteraemia is associated with high mortality. Although many models for predicting bacteraemia have been developed, not all have been validated, and even when they were, the validation processes varied. We identified validated models that have been developed; asked whether they were successful in defining groups with a very low or high prevalence of bacteraemia; and whether they were used in clinical practice. Electronic databases were searched to identify studies that underwent validation on prediction of bacteraemia in adults. We included only studies that were able to define groups with low or high probabilities for bacteraemia (arbitrarily defined as below 3% or above 30%). Fifteen publications fulfilled inclusion criteria, including 59 276 patients. Eleven were prospective and four retrospective. Study populations and the parameters included in the different models were heterogeneous. Ten studies underwent internal validation; the model performed well in all of them. Twelve performed external validation. Of the latter, seven models were validated in a different hospital, using a new independent database. In five of these, the model performed well. After contacting authors, we found that none of the models was implemented in clinical practice. We conclude that heterogeneous studies have been conducted in different defined groups of patients with limited external validation. Significant savings to the system and the individual patient can be gained by refraining from performing blood cultures in groups of patients in which the probability of true bacteraemia is very low, while the probability of contamination is constant. Clinical trials of existing or new models should be done to examine whether models are helpful and safe in clinical use, preferably multicentre in order to secure utility and safety in diverse clinical settings.
Topics: Bacteremia; Blood; Decision Support Techniques; Humans; Microbiological Techniques
PubMed: 25677625
DOI: 10.1016/j.cmi.2015.01.023 -
Revista Espanola de Quimioterapia :... Aug 2022The care of patients with a suspected infectious process in hospital emergency department (ED) has increased in the last decade to account for around 15-20% of all daily... (Review)
Review
The care of patients with a suspected infectious process in hospital emergency department (ED) has increased in the last decade to account for around 15-20% of all daily care. In the initial evaluation of these patients, samples are taken for the different microbiological studies in 45% of the cases, where obtaining blood cultures (BC) predominates, in 14.6% of all of them. The diagnostic yield of these BC is highly variable (2-20%). The most frequent suspected or confirmed foci or infectious processes of true bacteremia (TB) in the ED are urinary tract infection (45%) and respiratory infection (25%). For all these reasons, the suspicion and confirmation of TB has a relevant diagnostic and prognostic significance and requires changing some of the most important decisions to be made in the ED. Among others, indicate discharge or admission, extract BC and administer the appropriate and early antimicrobial. The intention of this review is to highlight the scientific evidence published in the last five years, clarify the current controversies and compare the ability to predict bacteremia of the latest predictive models published since 2017 with those already existing on that date, year in which a review was published that left open the proposal to continue searching for a model with adequate performance for ED. And so, based on it, generate different recommendations that help define the role that these models or scales can have in improving the indication for obtaining BC, as well as in the immediate making of other diagnostic-therapeutic decisions (administration early and appropriate antibiotic treatment, request for complementary tudies and other microbiological samples, intensity of hemodynamic support, need for admission, etc.).
Topics: Anti-Bacterial Agents; Bacteremia; Blood Culture; Emergency Service, Hospital; Humans; Retrospective Studies; Urinary Tract Infections
PubMed: 35413783
DOI: 10.37201/req/015.2022 -
BMC Infectious Diseases Jun 2013Fusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based...
BACKGROUND
Fusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based study to determine the relative proportion of species in this genus causing bacteremia and the risk factors for infection and adverse clinical outcomes.
METHODS
All cases of Fusobacterium spp. bacteremia detected at a regional microbiology laboratory serving outpatient and acute care for a population of approximately 1.3 million people over 11 years were identified from a computerized database. Clinical data on these cases was extracted from an administrative database and analyzed to determine underlying risk factors for and outcomes of infection.
RESULTS
There were 72 incident cases of Fusobacterium spp. bacteremia over the study period (0.55 cases/100,000 population per annum). F. nucleatum was the most frequent species (61%), followed by F. necrophorum (25%). F. necrophorum bacteremia occurred in a younger population without underlying comorbidities and was not associated with mortality. F. nucleatum bacteremia was found in an older population and was associated with underlying malignancy or receiving dialysis. Death occurred in approximately 10% of F. nucleatum cases but causality was not established in this study.
CONCLUSIONS
Fusobacterium spp. bacteremia in our community is uncommon and occurs in approximately 5.5 cases per million population per annum. F. necrophorum occurred in an otherwise young healthy population and was not associated with any mortality. F. nucleatum was found primarily in older patients with chronic medical conditions and was associated with a mortality of approximately 10%. Bacteremias from other Fusobacterium spp. were rare.
Topics: Adolescent; Adult; Aged; Alberta; Bacteremia; Cohort Studies; Female; Fusobacterium; Fusobacterium Infections; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Risk Factors; Young Adult
PubMed: 23734900
DOI: 10.1186/1471-2334-13-264 -
PloS One 2012The epidemiology of non-Typhi Salmonella (NTS) bacteremia in Africa will likely evolve as potential co-factors, such as HIV, malaria, and urbanization, also change.
BACKGROUND
The epidemiology of non-Typhi Salmonella (NTS) bacteremia in Africa will likely evolve as potential co-factors, such as HIV, malaria, and urbanization, also change.
METHODS
As part of population-based surveillance among 55,000 persons in malaria-endemic, rural and malaria-nonendemic, urban Kenya from 2006-2009, blood cultures were obtained from patients presenting to referral clinics with fever ≥38.0°C or severe acute respiratory infection. Incidence rates were adjusted based on persons with compatible illnesses, but whose blood was not cultured.
RESULTS
NTS accounted for 60/155 (39%) of blood culture isolates in the rural and 7/230 (3%) in the urban sites. The adjusted incidence in the rural site was 568/100,000 person-years, and the urban site was 51/100,000 person-years. In both sites, the incidence was highest in children <5 years old. The NTS-to-typhoid bacteremia ratio in the rural site was 4.6 and in the urban site was 0.05. S. Typhimurium represented >85% of blood NTS isolates in both sites, but only 21% (urban) and 64% (rural) of stool NTS isolates. Overall, 76% of S. Typhimurium blood isolates were multi-drug resistant, most of which had an identical profile in Pulse Field Gel Electrophoresis. In the rural site, the incidence of NTS bacteremia increased during the study period, concomitant with rising malaria prevalence (monthly correlation of malaria positive blood smears and NTS bacteremia cases, Spearman's correlation, p = 0.018 for children, p = 0.16 adults). In the rural site, 80% of adults with NTS bacteremia were HIV-infected. Six of 7 deaths within 90 days of NTS bacteremia had HIV/AIDS as the primary cause of death assigned on verbal autopsy.
CONCLUSIONS
NTS caused the majority of bacteremias in rural Kenya, but typhoid predominated in urban Kenya, which most likely reflects differences in malaria endemicity. Control measures for malaria, as well as HIV, will likely decrease the burden of NTS bacteremia in Africa.
Topics: Adult; Anti-Infective Agents; Bacteremia; Blood Specimen Collection; Child; Child, Preschool; Cost of Illness; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Feces; Humans; Incidence; Kenya; Malaria; Rural Population; Salmonella Infections; Salmonella typhi; Urban Population
PubMed: 22363591
DOI: 10.1371/journal.pone.0031237